1969 Conference on Food, Nutrition, and Health

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1969 Conference on Food, Nutrition, and Health

Part 3: Major Achievements by Federal Departments and Agencies

Many Federal agencies have made important contributions toward the goal of better nutrition. The accomplishments of agencies most affected by Conference recommendations are included in this summary.

1. Accepted two-thirds of recommendations

More than two-thirds of the White House Conference recommendations [that] referred to the Department of Agriculture were accepted and will have an impact on program direction.

2. Expanded Food Stamps

The largest body of recommendations affecting the Department of Agriculture relates to the food assistance programs operated by the Food and Nutrition Service. Prominent among these recommendations were proposals to liberalize the food stamp coupon issuance schedule. On December 18, 1969, the Department announced a new schedule providing increased bonuses and reduced purchase requirements for most families. The new schedule makes it possible for all participating families to purchase an adequate diet at a cost of no more than 33 percent of income. The following table demonstrates the effect of these interventions:

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These liberalizations produced a significant increase in program participation and costs, as outlined in the table below:

3. Improved Administration of Food Stamps

The Conference also urged close coordination of the food programs with the proposed Family Assistance Plan. The Department, in cooperation with the Department of Health, Education, and Welfare, is developing plans for the interfacing of these two programs. In June, the President announced his intention to transfer the Food Stamp Program to HEW in conjunction with implementation of the Family Assistance Plan. In the Administration’s June and October revisions of the Family Assistance Plan, it was also contemplated that a family could simply check a box on their FAP application and receive their food stamp benefits automatically.

In addition, to these steps, the Conference supported legislative efforts for the improvement of food stamp programs, including:

• simultaneous operation of food stamps and commodity distribution in program areas;

• permitting the aging to use stamps to purchase food either for home preparation or for prepared meals delivered to homes by non-profit agencies; and

• providing variable purchase plans for recipients, to give them more flexibility in coordinating their stamp purchase with availability of income.

The Administration has accepted their proposals in substance and has supported them in the Congress’ review of the food stamp amendments.

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4. Special nutrition programs for vulnerable groups

The Department is now experimenting with food certificate programs directed toward specific target groups, such as pregnant women and infants, to determine the effectiveness of such programs in improving their diets and health. The Department is also giving increased attention to improving the nutritional adequacy of the commodities being used in the commodity distribution program through such efforts as:

• enriching macaroni,

• providing iron fortification of farina and corn grits,

• recognizing regional preferences for varieties of beans,

• increasing the usage of instant dry milk to improve the acceptability of the milk distributed, and

• improving methods of distributing and delivering commodities.

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5. School lunches provided free or at reduced prices to low-income children

• increase the amount of Federal financial assistance available for free and reduced-price lunches,

• introduce education and training demonstration projects in schools, and

• finance evaluation studies.

6. Expansion of Nutrition Aides Program

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7. Better information and improved program evaluation

Accompanying these actions to improve and expand programs, evaluative efforts were undertaken to ascertain the effectiveness of alternative feed programs. The pilot program for assistance to pregnant women and infants included comprehensive evaluation as a part of the program from its inception. A special study of child nutrition programs was undertaken to examine alternative delivery systems. Program evaluation criteria in the Food Stamp Program are being changed to reflect a shift of emphasis from the impacts of food stamps on food expenditures to the nutritional adequacy of the diet provided with the stamps. Studies are also being initiated to improve the effectiveness of the Commodity Distribution Program until it is replaced.

8. Consumer Protection and Education

The Department of Agriculture is conducting extensive applied research on food habits and choices. Particular emphasis is being placed on the dietary patterns and problems in low-income areas to serve as a basis for developing the most effective techniques for improving diets through nutrition education and food programs.

Other research is being directed at the nutritional content of foods, including advantages gained through blending food components and through fortification with specific nutrients.

The Department is continuing to emphasize its cooperative information programs of working with industry and the media to create greater awareness of the importance of good nutrition. In line with Conference recommendations, special efforts are being made to:

• reach particularly vulnerable groups in the population—including low-income, ethnic, or age groups, and groups with language barriers;

• encourage participation in food programs;

• promote voluntary activity;

• emphasize food safety and the avoidance of food hazards; and

• increase consumer understanding of USDA standards, grades and labels.

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B. Department of Health, Education, and Welfare

1. Most Recommendations Accepted

Approximately 70 percent of the recommendations of the White House Conference [that] referred to the Department of Health, Education, and Welfare were accepted.

2. The Family Assistance Plan and better nutrition for the poor

Perhaps the greatest contribution that HEW could make toward upgrading the nutritional status of people at "high risk" is through the Administration’s Family Assistance Plan. This welfare-reform proposal includes many features—both administrative and programmatic—recommended by the Conference. For example, the inequity of variable eligibility and benefit standards between States will be virtually eliminated as national standards are applied. The payment for the aged, blind or disabled would nearly close the poverty-income gap for these groups.

3. Improved Program Coordination

As a direct result of the Conference recommendations, the Secretary of HEW approved the establishment of a Special Assistant for Nutrition Programs in the Office of the Assistant Secretary for Health and Scientific Affairs to provide a departmental focal point for all nutrition-related activities. Each regional director has also designated an individual on his immediate staff to coordinate nutrition activities at the regional level. These nutrition contacts will be particularly concerned with closer cooperation among Federal agencies.

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4. Strengthened Nutrition Program

The transfer of the Nutrition Program from the Regional Medical Program Service to the Center for Disease Control also provides emphasis to comprehensive nutrition programming within the Department. In CDC, the Nutrition Program will be able to provide direct service, program evaluation and review—in addition to technical advice and consultation with State and local health agencies. The Center is supporting twenty nutrition demonstration projects. These projects concentrate on geographic areas and special groups with identified nutrition problems, and are designed to provide for the active participation of the people served.

5. Surveillance

The Health and Nutrition Evaluation Study, a new component of the Department’s National Health Survey, will provide information about the nutritional status of the entire population on a regular basis, as suggested by several recommendations of the Conference. The results of this study will be used to provide data on a continuing basis to identify changing food and nutrition problems.

In other surveillance efforts, the Department will carry out surveys targeted on American Indians and certain migrant populations. The Maternal and Child Health Service expects to complete its study of child nutrition later this year.

6. Nutrition Education

Special efforts will be made to revise health curricula at the primary and secondary levels. Approximately eight pilot projects will be funded by the Office of Education to demonstrate creative approaches to linking existing school and community health resources, so that the multiple needs of disadvantaged children are met more adequately through the provision of a broad range of physical, mental health, and nutrition services. Nutrition education as an integral part of school lunch and breakfast programs will be included to improve the quality of health education. Initially, about two million dollars will be available for such demonstration projects.

The Office of Education is also developing a nutrition information guide on Child Feeding Programs and is drafting a curriculum guide of "Nutrition Education and the School Lunch in Elementary School."

In the area of improved professional nutritional education, the Center for Disease Control is developing teaching aids and programs for continuing education of professionals engaged in nutrition and nutrition-related activities. Particular attention will be given to curricula changes in medical and dental schools.

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7. Comprehensive Health Care

Various recommendations dealt with improvements in the health delivery system. The Administration has taken several steps toward upgrading present health delivery—particularly for the disadvantaged. The proposed Family Health Insurance Program, which would replace Medicaid for those poor families with children (including the "working poor"), is one of these steps. A total review of Federal health programs is also underway, and certain changes will be recommended by the President early in 1971. Meanwhile, every effort is made in departmental programs—both direct and indirect—to include a complete range of health services, including dental care, family planning, and screening for preventive care.

8. Food Safety

Many recommendations relating to food safety called for a comprehensive review of the list of foods termed "generally recognized as safe" (the so-called GRAS list). To implement these recommendations, the following steps have been taken or are planned:

1. The Food and Drug Administration is reviewing all items on the list and those which received "prior sanction." This review will focus on safety, appropriate use, and concentrations of certain substances in food.

2. Once the information is compiled, FDA will make a safety decision on each GRAS item, and item that received "prior sanction." The project is scheduled to be completed by the end of calendar 1971.

3. This review has been structured to facilitate a continuous analysis of GRAS items in the future through a data storage and retrieval system.

Along with the GRAS review, FDA is attempting to improve the safety of our food supply by improving the microbiological testing of foods. The laboratory methods of detecting common food microbial agents are being standardized and perfected in all FDA laboratories. Once this step is complete, FDA will train State, local and private testing laboratories in these standard methods.

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9. Nutritional guidelines

The Conference expressed concern over the increase in formulated foods, and the concomitant loss of consumer control over the nutritional quality of foods purchased. To offset any possible deterioration in the nutritional content of food, FDA is establishing nutritional guidelines for certain food classes (with the guidance of the National Academy of Sciences). These guidelines will suggest to food processors the minimum and maximum levels of nutrients that should be present in foods. By December, 1970, the suggested nutrient specificiations for one class of foods will be completed and submitted to the FDA for evaluation. By 1972 a major portion of the nutritional guidelines project will be complete and, through these guidelines, the foundation laid for a sound and comprehensive national food standards policy.

In addition to nutritional guidelines, nutritional specifications are being incorporated into new food standards when appropriate. For example, FDA has established a standard for an enriched macaroni product with improved protein content. This standard, if approved, will require a minimum quantity and quality of protein considerably above that now required for enriched macaroni. Protein quality and quantity specifications are also being written into vegetable protein products that simulate meat. A proposal for doubling iron fortification for flour and bread is also under review.

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10. Labeling for Nutritional Content

FDA has completed the first step in the development of a nutrient labeling program. After extensive discussions with nutritionists and consumers, FDA has developed three nutrient labeling plans that are now scheduled to undergo consumer acceptability tests.

The food industry has expressed great interest in nutrient labeling and many of the major food manufacturers and distributors are expected to use FDA’s nutrient labeling proposal. At the time nutrient labels begin to appear on market shelves, a cooperative food industry and FDA consumer education campaign is planned to teach the consumer how to best use the new labeling approach.

An improved labeling procedure for iodized salt has been prepared and a regulation written. The regulation will help consumers differentiate between iodized and non-iodized salt. Several proposals have also been written which will allow labeling of foods for fat content. These proposals are now being considered by the Commissioner of FDA.

C. Office of Economic Opportunity

1. Support of ongoing programs

Numerous activities of the Office of Economic Opportunity have had a direct impact on the implementation of Conference recommendations. In various parts of the country, OEO grants have been used to:

• pay the costs of administering school lunch programs on a temporary or start-up basis;

• purchase school lunches for eligible students who cannot afford the costs;

• administer school breakfast programs;

• provide senior citizens with hot, nutritious lunches; and

• expand local food assistance programs by providing additional warehouse space, and by facilitating certification and the issuance of Food Stamps and Commodities.

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2. Increased participation

To help facilitate greater utilization of food assistance programs, various OEO agencies have provided essential information and Outreach services. Legal Services lawyers have continued to provide information to as many clients as possible concerning opportunities for services.

3. Better methods of solving food problems

Contracts have been awarded to study marketing problems and possibilities for using fortified foods in various poverty areas. Grants have been made to analyze the school lunch program in an effort to achieve maximum cost-effectiveness, nutritional value, and acceptance.

4. Trained manpower

OEO has sought the alleviation of malnutrition and hunger through the training and use of aides to increase food manpower and improve food delivery.

OEO is currently addressing these and many other health and nutrition problems through its comprehensive neighborhood health centers and related programs.

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D. Federal Trade Commission

1. Revitalized consumer protection

One of the major purposes of the July 1970 reorganization of the Federal Trade Commission was to improve regulatory efforts in the vital field of consumer protection. Several steps have already been taken to insure that the regulation of food advertising receives greater emphasis and that staff efforts are more productive.

2. Creation of a new "food enforcement" unit

A special food enforcement section has been established within the Division of Food and Drug Advertising. Special monitoring procedures have been established to focus increased attention on food and beverage advertising, and the Commission is currently receiving scripts and story-boards from all major networks.

3. "Preventive enforcement"

The food enforcement section has formulated a program of preventive enforcement to insure that advertising does not mislead the consumer as to the nutritional value of food products.

First on the list of priorities are matters involving misrepresentations which may result in immediate and positive injury to the public health.

Second on the list of priorities are matters involving misrepresentations that indirectly affect the health or nutrition of the consuming public by diverting purchases from a nutritious product to a less nutritious substitute. For example, the Commission is currently instituting proceedings against certain manufacturers of "instant" meals. An industry-wide investigation of "diet" breads and soft drinks is being conducted.

Claims concerning the nutritional value of breakfast cereals, a staple in the diet of millions of children, are also being actively reviewed by the Commission staff. The Commission is also proceeding against certain candy manufacturers for making unwarranted nutritional claims in their advertising.

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4. Special protection of children

The Commission is devoting considerable attention to claims in advertising directed at children and to the advertising of food products consumed by children. Children are, by far, the most vulnerable to deceptive advertising of this nature and they play an important role in their parents’ choice of breakfast cereals, soft drinks, candy bars, and other foods.

E. Department of Labor

Recommendations affecting the Department of Labor fall into two main categories: expansion of employment opportunities in health and nutrition occupations; and assistance to seasonal agricultural workers.

1. Expansion of training and skill development program in health and
    nutrition occupations

Fifteen million dollars was added to training efforts for health occupation in 1971.

The Departments of Labor and HEW have established a Joint Committee on Heath Manpower to help develop closer working relationships at all levels in the area of medical and environmental health manpower. An experimental training program for physicians’ assistants has also been jointly developed to train returning veterans with medical corps experience to help doctors provide medical services in rural areas of Tennessee.

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2. Assistance to seasonal agricultural workers

The Department’s Annual Worker Plan is helping over 100,000 migrant workers to obtain steadier employment—and therefore better nutrition and health—through regularizing recruitment and scheduling. Unemployment Insurance coverage for migrant workers was included in the Administration’s proposed bill but was deleted in Congress. It will be proposed again in the next session of Congress.

F. Department of Defense

1. Better diets for military personnel

A joint service regulation was issued in March 1970 to improve the diets of military personnel. Daily menus now include a wider selection of food items. Legislation is being drafted to provide a uniform food allowance to all enlisted personnel.

2. Use of food stamps at commissaries and more purchasing power for low-ranking enlisted men

The Department of Defense has authorized the acceptance of food stamps for purchases of food items in military commissaries, and the Defense budget for 1971 included a proposed 20 percent pay increase for enlisted personnel in the lower ranks.

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3. Improved feeding arrangements

DOD is conducting an in-depth review of the military feeding operation. Several Conference recommendations will be incorporated into the long-range Research and Development Food Program initiated July 1970 by the U.S. Army Laboratories at Natick.

As recommended, the Army is testing the feasibility of consolidating multiple company size dining halls and utilizing central kitchen facilities. Fort Lewis, Washington, has been designated as a pilot test site to determine the extent of cost saving and improved food delivery.

G. Department of Interior

The Department of Interior is primarily responsible for the recommendations of the subpanels concerned with the Pacific and Caribbean Territories and American Indians and Alaska Natives.

1. Helping the American Indian

Several significant steps have been taken to alleviate the plight of American Indians and to hasten the development of water resources and other facilities to strengthen Indian agriculture:

• Increasing substantially the funding of the general assistance program for needy Indians to meet increased need. The Bureau assisted the Navajo Tribe and Tribes on four reservations in North Dakota by (1) helping the Navajo Tribe enter directly into an agreement with the Department of Agriculture to receive supplemental foods, and (2) assisting the North Dakota Tribes to enter into an agreement with the State of North Dakota to secure supplemental foods.

• Providing additional funds in 1971 for an inventory of critical water needs and for the first stage of construction of the Navajo Irrigation Project (which will shorten the time when water can be delivered to the first 10,000-acre increment of the ultimate 110,000-acre project)

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2. Improving nutrition in the Territorial Areas

Many recommendations were aimed at greater self-sufficiency in food production and less dependence on more expensive and nutritionally inferior imported foods. Although implementation is largely the responsibility of the Territorial governments, a number of steps have been taken:

• Increased commercial fishing is being promoted in all territorial areas, in order to provide more protein foods for the indigenous population and improve the economy; and

• Problem areas in developing a viable indigenous food industry have been identified.

H. Department of Justice

1. Initiated surveys of nutritional standards and food service facilities

The Bureau of Prisons has completed a program-wide nutrition survey to insure that inmates of Federal prisons and detention homes receive nutritionally adequate meals. The survey indicated that the diet of prisoners meets, and even exceeds, levels determined to be adequate.

Special attention is being given to ways to achieve the most efficient food service operation—including on-the-job training for inmates as well as food service personnel. Criteria for an on-the-job training program for personnel have been developed as part of a survey of food service facilities and operation.

2. Updated standard guidelines

As recommended by the Conference, the Administrator of Food Services has continued to update standard guidelines to assist prisons and detention homes in the proper rations of food and most efficient foods service operation. State and local officers are also provided with consultant and inspection services on request.

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